Affidavit for Purchase of Motor Vehicles

MEMBER #: _______________
or Other Vehicles for Resale—Blanket

I HEREBY CERTIFY:
1. I am engaged in the business of selling the following type of tangible personal property:
Motor Vehicles/Watercraft/Power Sports and/or Auto Parts
Other (please specify) ___________________________________________________________________
2. I am purchasing the following property from Copart and its Affiliates for resale:
Motor Vehicles
3. I will resell the item(s) listed in item 2 in the form of tangible personal property in the regular course of my business
operations, and I will do so prior to making any use of the item(s) other than demonstration and display while
holding the item(s) for sale in the regular course of my business. The specific property listed above is being
purchased for resale in the regular course of my business at the address listed on the sales tax license or dealer
license provided.
4. I intend to resell this/these vehicle(s) or salvage usable parts. If the “other” box is checked in line item 1, I certify
that although my main business may be in another industry, I am purchasing the item(s) listed in item 2 for resale.
5. I hold a STATE sales tax permit in the following states:
State: ____________ #: _____________________________
State: ____________ #: _____________________________
State: ____________ #: _____________________________
I do not hold a STATE sales tax permit in any other state because:
I do not make sales in any other state and/or a resale permit is not required in the state in which I will sell this
vehicle and/or auto parts.
6. I understand that if I use the item(s) purchased under this affidavit in any manner other than as just
described, I will owe tax based on each item’s purchase price or as otherwise provided by law.
7. I have read and understand the following:

A PERSON MAY BE GUILTY OF A MISDEMEANOR UNDER THE STATE SALES & USE TAX LAWS IF THE PURCHASER
KNOWS AT THE TIME OF PURCHASE THAT HE OR SHE WILL NOT RESELL THE PURCHASED ITEM PRIOR TO ANY USE
(OTHER THAN RETENTION, DEMONSTRATION, OR DISPLAY WHILE HOLDING IT FOR RESALE) AND HE OR SHE
FURNISHES A RESALE CERTIFICATE OR OTHER STATEMENT TO AVOID PAYMENT TO THE SELLER OF AN AMOUNT AS
TAX. ADDITIONALLY, A PERSON MISUSING A RESALE CERTIFICATE FOR PERSONAL GAIN OR TO EVADE THE PAYMENT
OF TAX IS LIABLE, FOR EACH PURCHASE, FOR THE TAX THAT WOULD HAVE BEEN DUE, PLUS A PENALTY MAY APPLY.

I DECLARE UNDER PENALTY OF PERJURY, UNDER THE LAWS OF THE STATE WHERE THIS DOCUMENT WAS EXECUTED,
THAT THE FOREGOING IS TRUE AND CORRECT.

Company Name

Signature of Purchaser, Purchaser’s Employee or Authorized Representative

Printed Name of Person Signing Title

Date Executed City/State where signed

Purchaser’s Address Purchaser’s Phone Number

Purchaser’s City, State and ZIP

Revised 2/18